The Centers for Medicare & Medicaid Services Friday released an interim final rule implementing changes to the special enrollment periods for public Health Insurance Marketplaces and rules for Consumer Operated and Oriented Plans. To discourage people from obtaining Marketplace coverage only when sick, which would negatively impact the risk pool, the rule requires most people who apply for a SEP due to a permanent move to have minimum essential coverage for at least one of the 60 days prior to the move. CMS will allow exceptions for people who were incarcerated or living abroad, among other circumstances. The CO-OP rule changes aim to help those organizations attract more private investment. CMS also encourages states to consider ways to facilitate marketplace stability, such as investigating state or local risk adjustment programs. The CO-OP changes take effect on the rule’s publication in the May 11 Federal Register, and the SEP changes take effect July 11. CMS will accept comments on the rule through July 5.